Medi-Cal Oversight & Compliance Manager

Department of Health Care Services; California; Hybrid; USD 75,000 - 95,000; Full time

Benefits offered by this job

Continuous training

Health insurance

Retirement program

Job summary

Itlearn360 is looking for a Staff Services Manager I in California to lead the Oversight Reporting Unit. Responsibilities include overseeing compliance with Medi-Cal regulations and managing reporting processes. This role requires analytical skills and the ability to direct staff.

The position offers telework options and a comprehensive benefits package that includes health insurance and retirement plans.

Qualifications

• Experience and understanding of Medi-Cal managed care and health care regulations.
• Demonstrated ability to plan, organize, and direct staff on complex workloads.
• Ability to identify areas for improvement and develop innovative solutions.

Responsibilities

• Lead the Oversight Reporting Unit ensuring compliance with regulations.
• Oversee development and implementation of monitoring processes and reports.
• Manage data analysis related to Medi-Cal performance.

Skills

Experience with Medi-Cal managed care

Analytical skills

Organizational skills

Proficient with Excel

Job description

Staff Services Manager I job at Department of Health Care Services. Sacramento County, CA.

Job Description and Duties

Why Join DHCS?

The Department of Health Care Services (DHCS) is the backbone of California’s health care safety net. Our success is made possible by the hard work of more than 4,800 DHCS team members and through collaboration with the federal government and other state agencies, counties, and partners for the care of low-income families, children, pregnant women, older adults, and persons with disabilities. This is an exciting opportunity to join our diverse team in the following role. If you are interested in joining our team, apply today!

About this Role:

The Staff Services Manager I (SSM I) leads the Oversight Reporting Unit (ORU) responsible for monitoring Medi-Cal managed care health plans (MCPs) to ensure compliance with state and federal regulations, contract requirements, and policy directives. Under general supervision, the SSM I oversees the development and implementation of standardized quarterly monitoring processes, tools, and reports. The role includes supervising analytical staff, managing data analysis related to MCP performance, and providing technical assistance to internal and external stakeholders. The ORU supports critical functions including grievance and appeal system oversight, legislative implementation, and quarterly monitoring. This position requires strong leadership, analytical, and communication skills, and plays a key role in ensuring accountability and performance within California’s Medi-Cal managed care system.

This position islocated in the Managed Care Quality and Monitoring Division, Managed Care Monitoring Branch, Oversight Section, Oversight Reporting Unit.

Have questions and/or need assistance? Contact [e-mail] , we are here to help walk you through the state hiring process!

This position is subject to the Department's Conflict of Interest Code and filing a Statement of Economic Interests (Form 700) when assuming office, annually while in office, and upon leaving office.

You will find additional information about the job in the .

Working Conditions

Please see the Telework and Salary Information section below for telework, reporting location, and temporary statewide salary reduction details.

Special Requirements

Simple Application Steps

If you are interested in this position, complete the following simple steps:

1. Review the education and experience minimum qualifications (MQ’s) of the Staff Services Manager I. See the Minimum Requirements section above.
2. Complete the Statement of Qualifications (SOQ) and the state application by clicking “Apply Now” above. See below for detailed application instructions.
3. Submit your application package with all required documents, which include the SOQ- see the "Required Application Package Documents" section below.
4. Once you have applied, take the Staff Services Manager IExamination.

Statement of Qualifications Section (SOQ):

Applicants must include a SOQfor this recruitment. The SOQ is a narrative discussion, not a cover letter, prepared by the applicant describing how their skills, knowledge, abilities, education, training, and experience, qualify them for the position. The SOQ serves as documentation of the applicant’s ability to present information clearly and provide DHCS additional information about their experience and qualifications concisely in writing. The DHCS may not consider applicants who fail to provide an SOQ with their application. Resumes do not take the place of the SOQ. The SOQ must be no more than twopages in length, single-spaced and using 12-point font. You must indicate your Full Name and Job Control Number at the top right corner. Candidates who do not complete and submit an SOQ may not be considered for this position.
Please describe the approach you would take to solve a complex problem, including the specific steps to analyze the issue, develop potential solutions, and implement the recommendation.

Desirable Qualifications

In addition to evaluating each candidate's relative ability, as demonstrated by quality and breadth of experience, the following factors will provide the basis for competitively evaluating each candidate:

-Experience and understanding of Medi-Cal managed care and healthcare regulations.
-Demonstrated ability to plan, organize, and direct staff on complex and diverse workloads.
-Ability to assess current processes, identify areas for improvement, and develop innovative solutions to streamline operations.
-Knowledge of or ability to quickly learn complex health policy issues related to Medi-Cal.
-Analytical, writing, and problem-solving skills.
-Understanding of basic data analysis and good working math and Excel skills.
-Experience researching health or other similar public policy issues and developing and presenting policy recommendations.
-Ability to gain and maintain cooperative working relationships with internal and external stakeholders.

Benefits

DHCS is dedicated to creating an innovative workplace for its team members that is inclusive, diverse, and interactive! Here are a few of the ways we stay engaged with our team:

• Continuous and ongoing training
• Diversity, Equity, and Inclusion program activities
• Employee Assistance Program (EAP)

Additionally, as a team member of the State of California, you may be eligible for many benefits, such as:

• Medical, including health, dental, and vision insurance.
• Paid Holidays and vacation/leave
• Defined retirement program
• Savings Plus Program (401(k), 457)
• Medical/Dependent Care Reimbursement Accounts

Full benefits information can be found on CalHR's

provides more information about our commitment to serving Californians and organizational excellence.

We need your help! Please let us know how you heard about our position by taking this brief optional survey: . This survey is not required to be considered for this position.

Telework Agreement

This position is currently eligible for telework up to three days per week and is required to report in person a minimum of two days per week. The amount of telework is at the discretion of the Department and is subject to change consistent with DHCS’ Telework Program and Government Code sections 14200 – 14203. Telework is available to California residents, and proof of residency may be required.

The DHCS office location for this position is at 1501 Capitol Avenue, Sacramento, CA 95814.

Required Application Package Documents

The following items are required to be submitted with your application. Applicants who do not submit the required items timely may not be considered for this job:

• Current version of the State Examination/Employment Application STD Form 678 (when not applying electronically), or the Electronic State Employment Application through your Applicant Account at All Experience and Education relating to the Minimum Qualifications listed on the Classification Specification should be included to demonstrate how you meet the Minimum Qualifications for the position.
• Resume is optional. It may be included, but is not required.